title: A randomized clinical trial comparing the impact of different oral hygiene protocols and sealant applications on plaque, gingival, and caries index scores.
abstract: OBJECTIVE
  This prospective randomized clinical trial investigated the impact of different tooth brushing strategies and sealant application on patients with fixed appliances: plaque, gingival, caries index scores, periodontal parameters, microbial, and molecular biological parameters were assessed.
  
  
  METHODS
  Fifty-five male and 63 female patients aged 11-15 years were enrolled in this 12-week, four-arm parallel-group trial. Patients of group 1 used a Sonicare FlexCare electric brush, patients of group 2 used a manual (elmex interX short head) plus interdental (Curaprox CPS 15) brush, and patients of group 3 and 4 used a manual brush only. The teeth of patients in groups 1, 2, and 3 were sealed with a filled resin (ProSeal). Patients were advised to brush twice daily and measured time spent brushing mornings and evenings [tooth brushing duration (TBD)]. Plaque (PIB, TQHI, MAPI) and gingival index (PBI) as well as caries index (DMFT/DMFS) scores were assessed at baseline and after 4, 8, and 12 weeks.
  
  
  CONCLUSIONS
  TBD did not differ significantly between patients using the electric or manual brush only (between 197 and 209 seconds) but was longer when using the combination of two manual brushes. TBD was slightly longer in the evenings. There was no gender difference. Although TBD was longer for the combination group, we failed to demonstrate any beneficial effect on outcome parameters for this group. No differences between sealed or unsealed tooth surfaces or for use of a manual or electric brush were observed.
authors.affiliation: Department of Orthodontics and.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zingler
authors.forename: Maria
authors.initials: M
authors.lastname: Pritsch
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Wrede
authors.forename: Björn
authors.initials: B
authors.lastname: Ludwig
authors.forename: Dirk
authors.initials: D
authors.lastname: Bister
authors.forename: Susanne
authors.initials: S
authors.lastname: Kneist
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lux
mesh_terms: D000293:Adolescent; D002327:Cariostatic Agents; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D003773:Dental Plaque / Q000517:prevention & control*; D003774:Dental Plaque Index; D003959:Diamines; D055615:Electrical Equipment and Supplies; D005260:Female; D005459:Fluorides; D005891:Gingivitis / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009910:Oral Hygiene / Q000295:instrumentation* / Q000379:methods; D010349:Patient Compliance; D010512:Periodontal Index; D010895:Pit and Fissure Sealants; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D014099:Toothbrushing / Q000295:instrumentation / Q000379:methods
chemical_list: D002327:Cariostatic Agents; D003959:Diamines; D010895:Pit and Fissure Sealants; C495399:Olaflur; D005459:Fluorides